Endometriosis occurs when endometrial implants that should normally line inside of your uterus — the endometrium — grows outside your uterus. Though these implants grow outside of your uterus, it still acts normally during your menstrual cycle, by thickening, breaking down and bleeding during your period. However, the blood from the endometrial implants has no outlet, which causes its surrounding areas to become inflamed and painful, triggering organ fusion and anatomical changes. Endometriosis most often involves;
- Your ovaries
- Fallopian tubes
- The peritoneum
- The lymph nodes
- The bowel
- The tissue lining your pelvis
Hardly does it endometrial tissue spread beyond pelvic organs.
Generally, endometriosis has no symptoms. But when symptoms are present, they can mimic the symptoms of other medical conditions such as; pelvic inflammatory disease (PID), ovarian cysts and irritable bowel syndrome (IBS)
Symptoms of endometriosis include:
- Severe abdominal and menstrual cramps during menstruation
- Lower back and pelvic pain is the most common symptom of endometriosis
- Painful and bloody bowel movements or urination, diarrhoea, constipation, and bloating especially during menstruation
- Spotting or bleeding between periods, shorter menstrual cycles usually before 27 days
- Abnormal or heavy bleeding during periods where the pad or tampon requires changing every 1 to 2 hours
- Nausea and vomiting
- Extreme pain during coitus
- Difficulty becoming pregnant
Pain is the most common noticeable indication of endometriosis, but the severity of the pain does not always equate with the extent of the disease.
What causes endometriosis?
The causes of endometriosis haven’t been clearly defined. The most popular theory suggests that menstrual blood with endometrial cells flows back through your fallopian tubes into your pelvic cavity where the cells stick to the organs instead of leaving your body through your vagina. This is known as retrograde menstruation.
Genetics can also a determining factor in whether you get endometriosis. There’s a high chance you’d get endometriosis if your mom or sister has it, there’s some proof that there’s a hereditary link. And the disease seems to be worse in the next generation.
Also, there’s a possibility of menstrual blood leaking into the pelvic cavity through a surgical scar, a good example is after a cesarean delivery.
There’s a chance that endometrial cells can be moved out of the uterus through the lymphatic system or due to a faulty immune system.
Then there’s the Mullerian theory that suggests that during the fetal period, endometriosis can develop from misplaced cell tissue that begins to respond to the hormones of puberty.
Several factors that can increase your chances of developing endometriosis, such as:
- Never giving birth; Pregnancy drastically reduces the risks of endometriosis progressing. Women who haven’t had children risk developing this disorder. However, there have been cases of women who have had a child or children and yet still develop this condition. It’s advisable for women to have children earlier as opposed to later.
- Starting your period at an early age, young girls who have their periods at an unusually early age risks developing endometriosis when compared to their counterparts who started at a normal age.
- Short menstrual cycles — for instance, less than 27 days
- Having higher levels of estrogen in your body or a greater lifetime exposure to estrogen your body produces
- Very Low body mass index
- Alcohol consumption and ingesting harmful substances
- One or more relatives (mother, aunt or sister) with endometriosis; there’s a hereditary link. If one of your family members have endometriosis, your chances of developing it would be a lot higher.
- Any medical condition that prevents the normal passage of menstrual flow out of your body
- Uterine abnormalities
Though the link between dietary choices and treating endometriosis are not concrete, there’s a study that shows that a diet rich in green vegetables and fruits is associated with lower risks of developing endometriosis. Also, avoiding caffeine can help reduce the pain, and a higher intake of red meats was linked with a higher risk. Taking active steps to choosing healthy foods can go a long way in managing the pain and effects of endometriosis.
Other options include:
Pain medications: Nonsteroidal anti-inflammatory drugs or NSAIDs (such as ibuprofen or naproxen sodium) are commonly prescribed to help relieve pelvic pain and treatment of painful menses. Since endometriosis occurs mostly during the reproductive years, many of the available medical treatments for endometriosis works by interfering with the normal cyclical hormone production by the ovaries. These medications include GnRH analogues, oral contraceptive pills, and progestin. Other medications such as Aromatase inhibitors and Danazol (Danocrine) may be recommended.
Surgery: Surgical treatment for endometriosis is recommended when the symptoms are severe or there has been an inadequate response to medical treatment. Surgery is the preferred treatment when there is an anatomic distortion of the pelvic organs or obstruction of the bowel or urinary tract. It may be classified either as conservative surgery, in which the uterus and ovarian tissue are preserved, or definitive system, which involves hysterectomy (complete removal of the uterus), with or without removal of the ovaries.
But, while surgical treatments can be very effective in the reduction of pain, the recurrence rate of endometriosis following conservative surgical treatment has been estimated to be as high as 40%. Many doctors recommend ongoing medical therapy following surgery in an attempt to prevent symptomatic disease recurrence.
Exercise, such as walking, may reduce pain and slow the progress of the condition by lowering estrogen levels.
Even though there is currently no affirmative cure for endometriosis, most women are able to relieve the pain of symptoms and will still go on to have children.